Summary

Will health care legislation mean "government funding of abortion"?

President Obama said Wednesday that’s "not true" and among several "fabrications" being spread by "people who are bearing false witness." But abortion foes say it’s the president who’s making a false claim. "President Obama today brazenly misrepresented the abortion-related component" of health care legislation, said Douglas Johnson, legislative director for the National Right to Life Committee. So which side is right?

The truth is that bills now before Congress don’t require federal money to be used for supporting abortion coverage. So the president is right to that limited extent. But it’s equally true that House and Senate legislation would allow a new "public" insurance plan to cover abortions, despite language added to the House bill that technically forbids using public funds to pay for them. Obama has said in the past that "reproductive services" would be covered by his public plan, so it’s likely that any new federal insurance plan would cover abortion unless Congress expressly prohibits that. Low- and moderate-income persons who would choose the "public plan" would qualify for federal subsidies to purchase it. Private plans that cover abortion also could be purchased with the help of federal subsidies. Therefore, we judge that the president goes too far when he calls the statements that government would be funding abortions "fabrications."

Analysis

Obama’s "Fabrications" Remark

Obama’s remarks Wednesday came during a telephone conference call to thousands of listeners, organized by religious organizations supporting his health care proposals. He said that "there has been a lot of misinformation in this debate, and there are some folks out there who are frankly bearing false witness." And then he lumped in abortion coverage at the end of a list of claims that he branded as untrue:

Obama, Aug. 19: We are closer to achieving that reform than we have ever been. And that’s why we’re seeing some of the divisive and deceptive attacks. You’ve heard some of them. Ludicrous ideas. Let me just give you one example, this notion that we are somehow setting up "death panels" that would decide on whether elderly people get to live or die. That is just an extraordinary lie. This is based on a provision in the House legislation that would allow Medicare to reimburse you if you wanted counseling on how to set up a living will or other end of life decisions. Entirely voluntary, it gives you an option that people who can afford fancy lawyers already exercise. That’s the kind of distortion that we’ve been hearing too much of out here.

We’ve heard that this is all designed to provide health insurance to illegal aliens. That’s not true. There’s a specific provision in the bill that does not provide health insurance for those individuals. You’ve heard that there’s a government takeover of health care. That’s not true. You’ve heard that this is all going to mean government funding of abortion. Not true. This is all, these are all fabrications that have been put out there in order to discourage people from meeting what I consider to be a core ethical and moral obligation, and that is that we look out for one another, that I am my brother’s keeper, I am my sister’s keeper. And in the wealthiest nation on earth right now, we are neglecting to live up to that call.

The White House did not post any transcript of the president’s words, but sponsors of the conference call, a coalition of faith-based groups supporting an overhaul of the health insurance system, posted the full audio of the president’s call on its Web site. His words come near the very end of the recording, and we transcribed them from the recording.

Abortion foes quickly denounced Obama’s statement as untrue. The NRLC’s Johnson said "the bill backed by the White House (H.R. 3200) explicitly authorizes the government plan to cover all elective abortions." And our analysis shows that Johnson’s statement is correct. Though we of course take no position on whether the legislation should allow or not allow coverage for abortions, the House bill does just that.

The House leadership’s bill (H.R. 3200) actually made no mention of abortion when it was introduced. Johnson refers to an amendment to the bill adopted by the House Energy and Commerce Committee July 30. Abortion rights proponents characterize it as a compromise, but it hasn’t satisfied the anti-abortion side. Offered by Democratic Rep. Lois Capps of California, the amendment was approved narrowly by the committee, 30 – 28, with most but not all Democrats voting in favor and no Republicans backing it. The Capps amendment states that some abortions "shall" be covered by the "public option" plan, specifically those types of abortions that Congress allows to be covered under Medicaid, under the so-called "Hyde Amendment," which has been attached regularly to appropriations bills for many years. These are abortions performed in cases or rape or incest, or to save the life of the mother.

As for other types of abortions, the Capps amendment leaves it to the secretary of Health and Human Services to decide whether or not they will be covered. It says, "Nothing in this Act shall be construed as preventing the public health insurance option from providing" abortion services that would not be legal for Medicaid coverage. Says the NRLC’s Johnson: "The Capps Amendment MANDATES that the public plan cover any Medicaid-fundable abortions, and AUTHORIZES the secretary to cover all other abortions. … [F]rom day one, she [Secretary Kathleen Sebelius] is authorized to pay for them all. And, she will."

We can’t say what anyone will do in the future. But Obama himself said on July 17, 2007, that "[i]n my mind, reproductive care is essential care" and would be covered by his public insurance plan. He was addressing Planned Parenthood:

Obama, July 17, 2007: We’re going to set up a public plan that all persons and all women can access if they don’t have health insurance. It will be a plan that will provide all essential services, including reproductive services, as well as mental health services and disease management services, because part of our interest is to make sure that we’re putting more money into preventive care.

The Capps amendment does contain a statement – as we noted in an earlier article – that prohibits the use of public money to pay for abortions, except in cases of rape, incest and to save the life of the mother. That would still allow the public plan to cover all abortions, so long as the plans took in enough private money in the form of premiums paid by individuals or their employers. The Capps language also would allow private plans purchased with federal subsidies ("affordability credits" for low-income families and workers) to cover abortion.

Supporters of abortion rights argue that this would cause some women who now have abortion coverage to lose it, by forcing private insurance companies to drop abortion coverage from plans so that they can be purchased with the help of federal subsidies. For example, NARAL Pro-Choice America states:

NARAL: Anti-choice members of Congress aren’t satisfied with the Capps compromise. They want to impose a new nationwide abortion ban in the private health-insurance market by prohibiting such coverage in the new health-care system – thus taking away coverage from women who already have it.

We can’t predict how many insurance plans might be affected by the Stupak language. And we take no stand on whether all abortions should or should not be covered.

As for the House bill as it stands now, it’s a matter of fact that it would allow both a "public plan" and newly subsidized private plans to cover all abortions.

– by Brooks Jackson

Update, Aug. 25: We have received letters on this subject from representatives of Planned Parenthood and the National Right to Life Committee, and have posted them in the FactCheck Mailbag.